CMS Price Transparency Data

Injection procedure for pain management

Facility: Sanford Usd Medical Center

Billing Code: G0260 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0260
  • Insurance Median: $871
  • Cash Discount Price: $1,790
  • vs. Medicare Baseline: 1.21x Medicare
The contracted insurance negotiated median rate for a Injection procedure for pain management at Sanford Usd Medical Center is $871. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,790. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 1.21x the Medicare baseline. Located in 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD.
Cash / Self-Pay
$1,790

Average discount available for prompt cash payment at this facility.

Insurance Median
$871

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$721.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $721.17 (100%)
Cash / Self-Pay: $1,790 (248%)
Insurance Median: $871 (121%)
Cash: $1,790 (248% of Medicare)
Ins. Median: $871 (121% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $721.17 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $307 - $870 43%
Sanford Health Plan $592 - $794 82%
Sanford Health Plan Align $658 91%
Ucare $706 - $1,572 98%
Medicare (plans) $713 99%
Health Partners $713 - $872 99%
Aetna $713 - $1,711 99%
UnitedHealthcare $713 - $1,971 99%
Primewest $725 - $727 101%
Security Health Plan $1,230 171%
Medica $1,508 - $1,613 209%
First Choice Health Network $2,013 279%
Healthez $2,013 279%
Multiplan $2,013 279%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD 57117
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals